Unfunded Mandates

The frustration of physicians of the endless unfunded mandates in an attempt to control health care costs is mounting.  An opinion piece in the Wall Street Journal by a 58 year old orthopedic surgeon is an excellent example of these complaints heard in any medical gathering.  The article a doctor's declaration of independence, elucidates the various complaints.  These include the electronic medical record with all its attendant problems, meaningful use demands for unnecessary clinical data to obtain payment, decrease of face to face time with patients, board recertification, and continual decrease in reimbursements by Medicare and Medicaid.

His suggestion is to stop taking Medicare or any insurance.  The problem is that Medicare and Medicaid pay approximately 30% of the total health care budget.  This is probably a low estimate, but without these funds hospitals would be unable to remain open.

When Medicare started in 1965, physicians and hospitals "hooked their wagons" to the government for higher and consistent reimbursements.  But like any government program, the system is constantly evolving in a negative entropy that appears to be unable to be stopped.  More regulations and more burdens are now the norm.

There is no easy answer for these problems, but physicians need to organize to protect their workplace environments only one of which is financial.  Hating the job is not in the patients' interest.  Their health and care is really the ultimate goal.

Guest Blogger - Jim Tate: EHR Incentives Drop Dead Dates

Several times a week I am asked the same question by providers and vendors. The question takes different twists and turns, but it all gets down to one core concern. To put it in the crassest terms, here it is. “What is the absolutely last drop dead date an eligible professional can meet the CMS EHR Incentive Program requirements and not leave any money on the table?” OK, now that the question is clear, let’s answer it once and for all.

For Eligible Professionals there are two CMS programs, Medicare and Medicaid, which incentivize EHR use. An EP must select one of the programs for participation, and is allowed to switch programs once. Let’s take a look at Medicaid first. 2016 is the “Last year to initiate participation in the Medicaid EHR Incentive Program” and 2021 is the “Last year to receive Medicaid EHR Incentive Payment.”

To continue reading this blog visit: http://www.hitechanswers.net/ehr-incentives-drop-dead-dates/

Jim Tate is a nationally recognized expert on the CMS EHR Incentive Program, certified technology and meaningful use and a partner in HITECH Answers. He is also author of The Incentive Roadmap® The Meaningful Use of Certified Technology: Stage 1.

HITECH Answers - www.hitechanswers.net

To purchase Jim Tate's book "The Incentive Roadmap The Meaningful use of Certified Technology: Stage 1 visit:  http://www.hitechanswers.net/products-page/

Does Medicare Reimburse for “Pharmectomies?"

Living in Florida, we see large number of elderly, chronically-ill patients with multiple medical problems.

These patients have multiple providers – primary provider, ED provider, nursing home provider, hospitalists, consultants, etc.

This leads to multiple treatments and prescriptions that have endless interactions and reactions.

After the medication reconciliation is completed on the Electronic Health Record (EHR), the process does not simplify.

So we have changed our process at my ED. Now if your medication bag weighs more the 5 lbs., we admit that patient to the hospital for a “Pharmectomy” - we eliminate all the medicines and start over. 


We are currently searching for a “surgical code” for this procedure as the reimbursement might be higher.